☆ Preface

Following the finalization of revisions to our nation's examination system and medical-related laws, the establishment of the Chinese Medicine Qualification Examination and Special Examination has fulfilled its phased objectives. The Chinese Medicine Qualification Examination was discontinued in 2006, and the Chinese Medicine Special Examination will also conclude by 2011. By this point, the training of clinical medical personnel in medicine, Chinese medicine, and dentistry in our country will fully transition to formal education to enhance medical quality and safeguard public health.

However, as the Chinese Medicine Special Examination approaches its termination, certain legislators have proposed amendments to specific articles of the "Specialized Professional and Technical Personnel Examination Act," seeking to revive the Qualification and Special Examination system. They have also put forward five highly contentious statements.

In response, the Chinese Medicine Department and Post-Baccalaureate Chinese Medicine Department of China Medical University, along with the Chinese Medicine Department of Chang Gung University, have conducted thorough research, gathered extensive data, and compiled a rebuttal to these five statements, presenting our own position.

### Rebuttal (1)

In response to the legislators' claim:

"Currently, the Chinese Medicine Departments and Post-Baccalaureate Chinese Medicine Departments established at China Medical University and Chang Gung University, according to data from the Department of Health, show that graduates of the Chinese Medicine Departments hold qualifications in both Chinese and Western medicine. Over 95% of these graduates practice as Western medicine physicians, let alone the expectation for them to remain in the field of Chinese medicine to promote this national heritage. Annually, only about 100 Chinese medicine practitioners are trained through formal education and the Chinese Medicine Special Examination, compared to 1,300 Western medicine practitioners per year. By the end of 2007, the total number of Chinese medicine practitioners nationwide was only 4,848, indicating a shortage of Chinese medicine practitioners to meet current healthcare demands."

☆ Clarification:

- The Post-Baccalaureate Chinese Medicine Department of China Medical University trains 100 Chinese medicine practitioners annually, with nearly 100% of graduates practicing exclusively in Chinese medicine.

- Since 2003, the Chinese Medicine Department of China Medical University has divided its enrollment into Group A (60 students) and Group B (60 students). Group A students are eligible for dual majors and may choose to practice either Chinese or Western medicine, while nearly all Group B graduates practice Chinese medicine.

- Although the number of graduates from Chang Gung University's Chinese Medicine Department is smaller, many still pursue careers in Chinese medicine.

Overall, the three departments across the two universities train at least 270 Chinese medicine practitioners annually, far exceeding the claim of "only about 100 practitioners trained" or "over 95% practicing as Western medicine physicians."

The Department of Health's ideal ratio is 22 Chinese medicine practitioners per 100,000 population. As of June 9, 2009, based on the licensing and practice registration data provided by the Department of Health's online search system, the total number of registered Chinese medicine practitioners in Taiwan was 5,266, or approximately 22.8 practitioners per 100,000 population—already exceeding the Department of Health's target.

Furthermore, the annual growth rate of Chinese medicine practitioners in 2007 was 2.5%, with no signs of decline. Thus, the claim that "there is a shortage of Chinese medicine practitioners to meet current healthcare demands" is unfounded.

### Rebuttal (2)

In response to the legislators' claim:

"On June 14, 2000, amendments to Article 13 of the 'Specialized Professional and Technical Personnel Examination Act' removed the provision that 'those who passed the Chinese Medicine Qualification Examination before the implementation of this amendment shall be eligible to take the Chinese Medicine Higher Examination or Special Examination for specialized professional and technical personnel.' This has rendered those who passed the Chinese Medicine Qualification Examination ineligible to take the Chinese Medicine Higher Examination for specialized professional and technical personnel."☆ Explanation:

According to the amendment proposal jointly submitted by 37 legislators on March 29, 2000, for Article 13 of the *Specialized Professionals and Technicians Examination Act*, the legislative intent clearly stated:
"To implement the education-examination-practice system for traditional Chinese medicine (TCM) practitioners, promote the long-term healthy development of TCM in our country, and maintain the principle of separating regular education-based selection from qualification examinations."
Additionally, the amended *Physician Act* promulgated on January 17, 2002, stipulated that those who passed the TCM qualification examination could only take the TCM special examination, which was to be abolished after 2011.

Article 9 of the *Specialized Professionals and Technicians Examination Act* states:
"Graduates from relevant departments, faculties, or institutes of public or registered private junior colleges or higher education institutions, or those from foreign junior colleges or higher education institutions recognized by the Ministry of Education, may take the higher examination for specialized professionals and technicians."

Moreover, the *Physician Act* explicitly stipulates that only those who have completed formal academic training, including clinical observation and internship, and obtained a graduation certificate are eligible to take the TCM higher examination.

If those who passed the qualification examination were allowed to take the TCM higher examination, would this not trivialize the formal education and training of TCM practitioners?

### Rebuttal (3)

In response to the proposal committee's claim:

"The amended *Physician Act* promulgated on January 16, 2002, under Article 3, Paragraph 3, stipulates that those who passed the TCM qualification examination were only eligible to take the TCM special examination before 2011. This amendment severely deprived those who passed the TCM qualification examination of their eligibility for the TCM special examination, seriously infringing upon the people's right to take examinations."

☆ Explanation:

The original purpose of establishing the TCM qualification and special examinations was to address the lack of systematic and comprehensive TCM education at the time. To ensure an adequate supply of TCM clinical practitioners for the public, the qualification and special examination mechanisms were introduced to provide a legal pathway for those who were self-taught or had family traditions in traditional medicine.

With the passage of time, institutions such as China Medical University and Chang Gung University have successively established programs like the "Department of Chinese Medicine," "Post-Baccalaureate Program in Chinese Medicine," and related graduate institutes, offering standardized and modernized TCM training tailored to contemporary medical needs. The TCM clinical professionals trained through these programs have indeed met the demands of Taiwanese society. Those aspiring to pursue TCM can also join the field through university recommendation, entrance examinations, or the Post-Baccalaureate Program in Chinese Medicine admissions process. There is no infringement upon the people's right to take examinations.

The amendment to Article 3 of the *Physician Act* on January 16, 2002, stated:

"Those who passed the TCM qualification examination may take the TCM special examination only before the year 2011."

The intent of this provision was by no means to deprive those who passed the TCM qualification examination of their eligibility for the TCM special examination. Rather, while phasing out the qualification and special examination systems, it granted those who passed the qualification examination a transitional period to continue taking the special examination—a so-called "sunset clause."

Yet, this has now been distorted as an act of cutting off the eligibility of those who passed the qualification examination. Such claims severely misrepresent the original legislative intent.Defense (4)

In response to the proposal committee's submission:
"According to the current 'Professional and Technical Personnel Examination Act,' Article 12:
'Before the amendment and implementation of this Act, those who passed the higher or ordinary qualification examinations shall respectively obtain the eligibility to take the higher or ordinary examinations for professional and technical personnel in equivalent categories or special examinations of equivalent levels and categories.'
This provision safeguards the examination rights of individuals who passed qualification examinations for up to 40 categories, such as physicians, dentists, and pharmacists. However, it exclusively excludes those who passed the Chinese medicine practitioner qualification examination from obtaining eligibility for the higher examination of professional and technical personnel under Article 13 of the same Act.
This clearly violates the constitutional guarantee of the people's fundamental right to take examinations and contravenes the principle of equality. Therefore, we propose an amendment."

☆ Explanation:

This issue overlaps significantly with points two and three. Hence, the following excerpts are provided to elaborate on the relevant information.

[Excerpt from the *Annual Report on Chinese Medicine*, Vol. 26, Book 3, pp. 129–130]

In 1966, China Medical College (now China Medical University) was approved by the Ministry of Education to establish the Department of Chinese Medicine (note), training professionals in Chinese medicine with a six-year program. Starting from the second cohort, the program was extended to seven years (including one year of internship), marking the beginning of formal education in Chinese medicine.
At the time, formal education in Chinese medicine was not yet widespread (the first graduating class of 43 students was produced in 1972). However, there were many self-taught individuals in the private sector who lacked equivalent qualifications and were thus unable to take the special examination for Chinese medicine practitioners to obtain licensure. Given the strong societal demand for Chinese medicine practitioners and to preserve this national heritage and sustain the development of Chinese medicine, the Ministry of Examination held several discussions with relevant parties.
It was unanimously agreed that to elevate the academic standards of Chinese medicine practitioners and encourage those aspiring to work in the field to advance their studies, a Chinese medicine practitioner qualification examination would be conducted as a stepping stone for practitioners before formal education in Chinese medicine became widely established.
On May 4–5, 1968, the Ministry of Examination held the first Chinese medicine practitioner qualification examination in Taipei, with 1,511 applicants, 1,464 examinees, and 158 passing, resulting in a pass rate of 10.79%. This marked the inception of the Chinese medicine practitioner qualification examination in our country.

On December 29, 1999, and June 14, 2000, amendments to the *Professional and Technical Personnel Examination Act*, Article 13, stipulated that the Chinese medicine practitioner qualification examination would continue to be held five times between 2001 and May 2005. From 2006 to 2008, only supplementary examinations were held for those who had failed certain subjects in previous examinations, and the examination was discontinued starting in 2009.
From its first administration in 1968 to 2005, the Chinese medicine practitioner qualification examination was held 33 times, with a total of 240,155 applicants, 191,102 examinees, and 20,898 passing, yielding an average pass rate of 10.94%.

For a long time, there has been a significant disparity between the development of Western and Chinese medicine in our country. While Western medicine has advanced to world-class standards, Chinese medicine has primarily developed outside the formal system. To align with international trends following our accession to global organizations, ensure the quality of Chinese medicine practitioners, and promote the proper development of Chinese medicine education,

the Examination Yuan and the Department of Health have held multiple public hearings on the matter. In addition to considering the attached resolution, they have widely incorporated opinions from various sectors. To align with the quota control policies of health and education authorities, ensure the standard of Chinese medicine practice, and strengthen international competitiveness, a policy was established to guide the cultivation of Chinese medicine practitioners in our country onto a formalized track.After careful deliberation, it was decided to reintegrate the training and selection of Chinese medicine practitioners into the formal education system.

The Professional and Technical Personnel Examination Act and the Physicians Act were amended and passed by the Legislative Yuan on January 1, 2001, and January 6, 2002, respectively.

A 10-year gradual transition plan was adopted, with a sunset clause explicitly stipulated for the Chinese Medicine Practitioner Special Examination.

It was stipulated that those who passed the Chinese Medicine Practitioner Qualification Examination could take the Chinese Medicine Practitioner Special Examination before 2011.

**Reply (5)**

In response to the proposal raised by the committee members:

"In Taiwan's education system, after completing a bachelor's degree, the next academic degree pursued is a master's degree.

To apply for a master's program entrance exam with equivalent qualifications, such qualifications must be equivalent to a bachelor's degree.

According to the amendment issued by the Ministry of Education on December 28, 2006 (Document No. 0950191616C), Article 3 stipulates that those meeting one of the following qualifications may apply for a master's program entrance exam with equivalent qualifications.

Item 6 states: 'Those who have obtained a Class A technical certificate or an equivalent single-level technical certificate and have at least three years of work experience, with supporting certificates and documents,' are considered equivalent to a bachelor's degree.

Upon reviewing the eligibility criteria for the Higher and Ordinary Examinations for Professional and Technical Personnel in Fire Protection Equipment,

For the Fire Protection Equipment Technician category, eligibility item 3 requires passing the Ordinary Qualification Examination,

While item 5 requires passing the Level B technical skills certification for refuge system fire safety equipment.

Therefore, passing the Ordinary Qualification Examination and obtaining Level B technical skills certification are listed as equivalent eligibility criteria,

Implying that both are evaluated as equivalent.

In other words, passing the Ordinary Qualification Examination is equivalent to obtaining Level B technical skills certification.

By the principle of 'a fortiori,' passing the Higher Qualification Examination or the equivalent Chinese Medicine Practitioner Qualification Examination

Is equivalent to obtaining a Class A single-level technical skills certification.

In summary, passing the Higher Qualification Examination or the Chinese Medicine Practitioner Qualification Examination is equivalent to holding a Class A single-level technical certificate.

Thus, those who have passed the Higher Qualification Examination or the Chinese Medicine Practitioner Qualification Examination, with supporting certificates and documents,

Are considered equivalent to holding a bachelor's degree and may take the master's program entrance exam.

Moreover, they are naturally eligible to apply for post-baccalaureate Chinese medicine programs."

**Explanation:**

- Using the regulations for the Higher and Ordinary Examinations for Fire Protection Personnel to argue that passing the Chinese Medicine Practitioner Qualification Examination grants equivalent qualifications to a bachelor's degree and related exam eligibility

Is essentially comparing two entirely different fields.

Such an "assumptive" argument is highly negligent

And disregards the health and well-being of the public.

Fire protection personnel have their own professional expertise,

And Chinese medicine practitioners have theirs—

The two should never be conflated.

**Comparison of Eligibility Criteria for the Chinese Medicine Practitioner Special Examination and the Chinese Medicine Higher Examination**

Special Examination for Traditional Chinese Medicine Practitioners

Special Examination Regulations for Professional and Technical Personnel - Traditional Chinese Medicine Practitioners Examination, Article 6 Citizens of the Republic of China who have passed the Traditional Chinese Medicine Practitioners Qualification Examination may take this examination.

Higher Examination for Traditional Chinese Medicine Practitioners

Higher Examination Regulations for Professional and Technical Personnel - Traditional Chinese Medicine Practitioners Examination, Article 5 Citizens of the Republic of China who meet one of the following qualifications may take this examination: 1. Graduates from a public or accredited private university, independent college, or a foreign university or independent college recognized by the Ministry of Education, with a degree in Traditional Chinese Medicine, who have completed their internship with a passing grade and hold a graduation certificate. 2. Before January 17, 2002, graduates from a public or accredited private university or independent college with a degree in Medicine, who have completed the following courses in Traditional Chinese Medicine: Basic Theory of Traditional Chinese Medicine (including Huangdi Neijing, Nan Jing, Introduction to Chinese Medicine, and History of Chinese Medicine) for 7 credits, Traditional Chinese Medicine Diagnostics for 4 credits, Chinese Materia Medica for 6 credits, Traditional Chinese Medicine Prescriptions for 4 credits, Traditional Chinese Internal Medicine (including Shanghan Lun and Jin Gui Yao Lue) for 13 credits, and Acupuncture for 5 credits, as well as at least two of the following courses: Traditional Chinese Ophthalmology, Traditional Chinese Traumatology, Traditional Chinese Gynecology, Traditional Chinese Pediatrics, or Traditional Chinese Surgery, each for 3 credits, totaling at least 45 credits. They must also provide proof of these credits and have passed the Physician Examination, holding a physician’s license. 3. Graduates with a double major in Medicine and Traditional Chinese Medicine who have completed their internship with a passing grade, hold a graduation certificate, and have passed the Physician Examination, holding a physician’s license. For those applying with foreign academic qualifications, in accordance with Article 4-1 of the Physician Act, if the qualifications are from countries or regions other than the United States, Japan, Europe, Canada, South Africa, Australia, New Zealand, Singapore, or Hong Kong, they must first pass the academic qualification assessment by the Ministry of Education before being eligible to take this examination.

Thank you for taking the time to read such a lengthy article.

The Special Examination for Traditional Chinese Medicine Practitioners was established to meet the needs of its time, but the current context has greatly changed.

The formal education system for Traditional Chinese Medicine is now complete, and the Special Examination for Traditional Chinese Medicine Practitioners should rightfully retire.

It is unreasonable to demand the revival of the special examination at this time.

Here, the Student Association of the Traditional Chinese Medicine Department at China Medical University,
the Student Association of the Post-Baccalaureate Traditional Chinese Medicine Department at China Medical University,
and the Student Association of the Traditional Chinese Medicine Department at Chang Gung University,

jointly reaffirm our stance and firmly oppose Proposal No. 9113.

Source: http://bbs. cmu. edu. tw/ bmore? DepBaccalaur& 393